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Dysphagia Care Pathway in MND

Attributed to Manchester. Dysphagia Care Pathway in MND. Diagnosis MND. Baseline swallowing and nutritional assessment. No symptoms identified. Needs led review (minimum every four months). Symptoms identified. 1. Further assessment SLT intervention Modified textures

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Dysphagia Care Pathway in MND

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  1. Attributed to Manchester Dysphagia Care Pathway in MND Diagnosis MND Baseline swallowing and nutritional assessment No symptoms identified Needs led review (minimum every four months) Symptoms identified • 1. Further assessment • SLT intervention • Modified textures • Compensatory swallow • techniques • Use of aids, prosthesis • Modification of daily • eating patterns • 7. Introduction of concept • of alternative feeding and • written information. • MNDA Fact Sheet 14 Referral to dietician Needs led review (minimum every six weeks) Symptom Progression 1. Consideration of alternative feeding if: . Failure to meet nutritional requirements on an oral regime . Severe of dysphagia is increasing . Probability of aspiration . Unable to take medications orally . Significant decrease in FVC (approaching 60%) . Sudden weight loss . Fatigue associated with inadequate nutrition 2. Liaise with MDT 3. Discuss with patient and carer re alternative feeding Needs led review (minimum every six weeks) Needs led review (minimum every six weeks) Patient decision re future management of nutritional intake Combination of oral and alternative feeding Alternative feeding Continue with reduced oral intake as tolerated SUPPORT PATIENT DECISION GNDH/29.12.05

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